Paralyzing fears

Imagine fearing the outside world. Not terrorists or criminals
or drunk drivers, but the dozens of other faces you’d encounter
simply by going to the grocery store. Or fearing running into the
man walking his dog down your street who may see you trip and
think,
”
How clumsy.
”
Imagine fearing the outside world. Not terrorists or criminals or drunk drivers, but the dozens of other faces you’d encounter simply by going to the grocery store. Or fearing running into the man walking his dog down your street who may see you trip and think, “How clumsy.”

Social anxiety, the blanket term for a variety of phobias that transport sufferers to this panic-stricken state is experienced by as many as 6 percent of Americans to some degree, varying from light touches to phobias so profound some sufferers haven’t left their homes in years.

Nearly everyone experiences some form of this fear – the feeling that somehow they will be publicly humiliated or embarrassed – usually as simple stage fright, said Barry Goldman-Hall, a licensed clinical social worker and clinical director for Community Solutions in Morgan Hill. Persistent social anxiety issues related to social situations are most often seen in adults, he added.

Sufferers of social anxiety most often report fear of extreme embarrassment or humiliation, and many feel that they’re being watched in social situations, even if they can logically understand that this is not the case, said Jerry Mermis, a mental health clinician for San Benito County Mental Health.

“For some people it might be so bad that therapy is very, very slow,” said Mermis. “Them getting to the office is one challenge they’ll have to overcome, but you have to keep it broken down into steps.”

Depending on the level of anxiety, Mermis may begin by suggesting a patient walk outside his or her house and get in the car every morning for a week.

Then he might suggest going outside, getting in the car and driving to the grocery store just to sit in the parking lot, followed by a week where the patient goes through the motions of driving to the store and actually walking inside without even shopping.

“You try to build up one step at a time and do it in small enough pieces that they can bite off,” said Mermis, who noted that many patients with social anxiety issues tend to see the world in all-or-nothing terms. “There’s that feeling that’s just turned into this unimaginable nightmare, and you have to break it up into chewable pieces.”

The symptoms that go along with this phobia aren’t just mental.

The fear patients feel is real, and they may experience everything from anxiety to heart palpitations and cold sweats, according to Goldman-Hall, but the condition is considered highly treatable.

A variety of medications like Paxil can help alleviate symptoms, and drugless therapies are available as well, said Goldman-Hall, but patients are generally shy of talking about the condition.

Though the South Valley Newspapers contacted several care providers, including a specialized social anxiety treatment facility, no patient who suffers from the condition and was willing to comment for this story could be found.

For people whose phobia is tied to one specific trauma – an event of abuse or a very public form of molestation, for example – psychotherapy can be a highly effective treatment on its own.

But for anxieties that are not tied to any definitive event, there may be a need for more intervention, said Goldman-Hall.

The most common treatment for social anxiety is behavioral desensitization, a therapy in which sufferers are exposed to situations that approximate more and more the very acts that frighten them, be it spending time with a large group of friends or dining in a crowded restaurant.

“You begin by just talking about the events that create anxiety,” said Goldman-Hall. “Then you approximate it. You go for a walk in a safe place or you try a flight simulator, but the key is that it’s something where a patient has an out until they’re ready for the experience that causes them fear.”

Some solutions that can reduce, though not necessarily eliminate these anxieties, are even simpler. Mermis works with patients on simple tension relievers like taking deep breaths to avoid hyperventilation, counting to 10 to avoid panic reactions and focusing on the positive.

“There are some behaviors socially anxious people may have gotten into the habit of,” said Mermis. “I like to call them automatic negative thinking.”

These include thoughts that hold patients back, like black and white thinking, blaming, fortune telling or viewing each social situation as a catastrophe waiting to happen.

Patients with these habitual mindsets often don’t recognize that they’re ruling out the positives in their lives and then accepting the very bleak, lonely world they have invented for themselves.

“You’re helping the client identify things that they’re doing, and they’re thinking that have become subconscious,” said Mermis.

For more information on social anxiety, contact a licensed therapist or credible counselor. A variety of services are available in the South Valley, but if you’re not sure where to start, try Community Solutions at (408) 779-2115 or call San Benito County Mental Health at (831) 636-4020.